OCD Treatment - How to do Exposure and Response Prevention

In this video, I talk about the Exposure and Response Prevention and how it applies to OCD treatment. The whole premise of ERP is to expose yourself to something that triggers your anxiety and prevent yourself from responding with compulsions. When you do this correctly you allow yourself to achieve habituation and successfully overcome your fears. In this video, I give a brief description of how to apply ERP with OCD treatment.

Video Transcript

00:00 All right. Hello and welcome to this episode where I'm going to talk about exposure and Response Prevention. My name is Matt. I'm a licensed clinical social worker, know most of the founder of the OCD Academy. And in this series I really am trying to answer as many questions as I can, kind of the frequent questions that I get an explained some just just overall concepts of the OCD treatment and the OCD recovery process because I just know that there's a lot of misinformation and disinformation out there and I want to offer some clear guidance on, on really what OCD treatment is, how their recovery process works, especially if you do struggle with ocd or you know, someone who does like a family member on to make sure that you have clear guidance in that really is the entire purpose of, uh, of this series. So in this, um, and, and again, all these episodes kind of build off each other.

00:50 So if you have, if you're just starting on this video, please go back and starting in the first, first one, because I'm in this, in this, uh, I'm going to be real. I'm referring to concepts that I talked about in previous videos as well. So, um, let's, let's go ahead and answer this question of what is Erp, right? And so if you've explored OCD treatment at all, chances are you've probably come across this term called exposure and Response Prevention, right? And it sounds Kinda, you know, it sounds pretty intense when you, when you hear about it and then you, you read about ocd treatment and someone's like, okay, well you need to go and face all your fears and you need to go and do the exact things that um, you know, you don't want to do and that's how you get over OCD, right?

01:33 And people will say all sorts of things like that and, and all of that is true two degrees, but really there's ways that exposure and response prevention, there's ways to do it right? And then there's ways to um, not do it. Right, right. And so when we talk about exposure and Response Prevention, let's just go ahead and dive into what it is. So exposed exposures, right, really just means to experience, right? It, it just experienced something that is going to, uh, you know, like some kind of stimulus, so to speak, or something that triggers your fears or whatever. Right? It's an instant exposure to something. Right? So for instance, if you have contamination, OCD, the exposure might be to touch something that you perceive as contaminated, right? That's the exposure part. Now their response prevention part is to prevent yourself from responding in a compulsive way that's going to reinforce that fear.

02:30 Okay? So what we do when we come to the contamination, it's like, okay, well I'm going to touch something that could be contaminated. Then I'm going to prevent myself from washing my hands because I know that that's going to reinforce that loop. Okay? And so why Erp works is because, well, there's kind of a several reasons that we focus on Erp when it comes to ocd recovery, it ends because one, our behavior is way more in our control. Then whatever thoughts we're having or whatever feelings were. So because we have more control over our behavior, we have, you know, a higher probability that we can change it, so to speak. When we try to change our thoughts, we know that doesn't work and we try to change our feelings. We know that doesn't work too, but we can change how we react to things. And through the transtheoretical model of behavior change, which I talked about in the last episode, you know, that's what we, what we focus on is really this idea of starting to implement behavior change.

03:25 And so, um, to explain this, um, let me go ahead and talk about a story real quick. Uh, so like, um, you know, this is a story that is in the book ocd treatment through storytelling by Dr Alan Wagg and, but it's also something that just everyone can experience or everyone has experienced and it's just really this idea of watching a scary movie. So when I was going through treatment, I'm one of the, the, the things that I had to do a, you know, on my own, on my own journey to recovery was watch scary movies, right? And so, you know, I had a big fear at one time about, um, demons, right? And that was like a, a thing that I was a very, you know, it was really, really terrifying to me. Right. And I was really in this kind of, you know, this obsessive compulsive loose around this idea of like, well, what if I got possessed or you know, what if someone I noted and all that stuff.

04:17 So one of the things I had to do is watch a scary movie and, or watch movies that involve this idea of a demons and stuff. So one of the movies that I watched was the exorcist, right? And this was part of my, you know, process of facing fear. And um, so for those of you who haven't seen the excess, it's a, it's a pretty famous movie about this girl that gets possessed by ID. Right? And the exorcist is the person who actually goes and tries to help get her on possessed, so to speak. Right. Exercise her, so to speak. Um, but anyways, um, so the first time I remember, you know, with the people that were there helping guide me on my treatment process, you know, we're like, oh, you're going to watch the exorcist. And I was like, no, I'm not, I promise it's not happening, you know.

05:04 And uh, so it was very resistant to it. Right. And that's one of the problems with the RP is that, you know, a lot of people will just throw you in the water and say, oh, go do this. And when you don't do it, they get upset with you. And then you know, the relationship kind of unfold. So a good guide or a good therapist, what they'll do is they'll set up things that are going to build your confidence to ultimately face down fears and kind of a systematic way. And if something's too difficult for you, you should probably move down the scale and try something a little easier to build your confidence so that you can do that. That thing that's a little more difficult. So when it comes to the watching, the exorcist was definitely something that was a little bit higher on my hierarchy.

05:41 And the thing is, is that when you watch the movie, uh, the, you know, the first time I lost it and I had seen it before, but when I, you know, when you're really caught in ocd, I watched it again and uh, you know, the first time I watched you, it was just as terrifying experience. You know, I remember like I was just super anxiety for every um, you know, all the sounds and just every scene. It was just a very, very rough experience. Now, one of the things that I did though was that I have a certain scene in the movie triggered me or provoked a lot of anxiety and fear. What I do is I want every wine that scene and watch it again and again and again and again. And what happens is, is the more that I experienced that scene and didn't do any compulsive behaviors, what happened was, is that eventually that scene, that shock value just didn't happen.

06:29 Right? So when you watch the scene the first time, it might be really scary, but the second time you watch it, it's not as bad. The 10th time you watch it, it's really not that bad. And then by the 20th time you're like, what is this? You know, you, you know the dialogue, you know exactly what's going to happen. The music is there and because you've experienced so much and preventing yourself from responding, what happens is, is that you habituate to that scene and that's probably the best parallel that I can present because that's the really the whole goal of Erp is habituation. It's this idea of learning to habituate to our, to our exposures are, um, to our experiences that trigger fear. And we do that through repetitive exposure and the more and more we experienced it, the less and less it stimulates those, those feelings and those fears ix specifically when we prevent ourselves from responding and compulsive way.

07:20 So I know I'm throwing a lot of words out there, so I want to make sure this is clear. And so the, and then, you know, so as I went through the movie, I would rewind these scenes and, you know, just wash them again and again, and eventually I habituate and now I could watch a movie and it's not going to bother me. No, because I've seen all the scary scenes so many times. It's just like I know exactly what's going to happen and more Portland know what's going to happen within me because like internally, because, um, you know, it, it's something that I just experienced again and again to the point where it has no state has no reaction anymore. And that really is the goal and why exposure and response prevention works so well is because, um, you know, through this like kind of phenomenon of habituation when you've kind of trained yourself that you don't need to react in a compulsive way.

08:03 And the only way you can do that though is by directly confronting and experiencing your feared, feared objects are feared situations or feared thoughts or whatever. And so, um, in the, in the next, in the next episode, I'm going to talk about this idea of Erp. When it comes to pure ocd, um, and you know, where you may not think you have a lot of physical compulsion compulsions, and then I'm going to talk about how to develop a hierarchy neck. So hopefully, um, you know, that was a, that was helpful and understanding the concept of Erp and how it works and how, you know, I applied it in, in a one specific instance. Now granted, there's many different exposures that I've done. Um, but that's, that whole phenomenon of a situation is really the goal of Erp. And so the, one of the most important things that you can do on your recovery though is really identify all the different compulsion's that you do so that you know what to prevent yourself from doing when you do exposures.

09:00 And so what I did is I put together a compulsion inventory that I have down below and, um, in the, in the notes. And so please be sure to get that it's free. And so you just can click the link, you'll go to a patriot, can download it. And um, and that will help you identify a lot of the compulsive behaviors that you might be doing so that you can be successful with this erp process. And so with all that said, again, free resources down below in the notes, be sure to like and subscribe I'm, and there's a little bell I think you can click that will help notify you in the next episode is up and going. And um, so and then also, uh, be sure to head on over to the link below and so you can claim your free compulsion inventory and then that way you can start filling that out and, and knowing the behaviors that you need to start eliminating on this Erp with this erp process. So thanks so much for tuning in. It's been a pleasure to be here with you guys. And I will see you guys in the next episode where we're going to talk more about Erp.

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